ProjectSummary Overthepastdecade,HIVinfectionshaveincreasedby87%amongyoungmenwhohavesexwithmen (YMSM)ofcolor.ReversingthistrendwillrequiretheuseofHIVpre-exposureprophylaxis(PrEP).However, increasingPrEPaccessalonewillnotchangethefaceoftheepidemic.AsPrEPefficacyishighlycorrelated withlevelsofadherence,andnoevidencebasedinterventionsyetexisttosupportPrEPadherence,itwillbe crucialtoidentifyfactorsassociatedwithimprovedadherencetoPrEPinYMSM.Socialsupporthasbeen describedasafacilitatorofadherenceinqualitativedatafromPrEPtrials.Understandinghowsocialsupport operatesinthePrEP-adherencerelationshipisessentialpriortodevelopingpotentialsocialsupport-based interventionstooptimizePrEPadherence.However,nostudieshaveyetformallyanalyzedthepotential associationbetweensocialsupportandPrEPadherenceamongYMSM. InresponsetothecriticalneedforresearchdelineatingtheroleofsocialsupportinPrEPadherencefor YMSM,weproposethefollowingspecificaims:1)todiscoverthemesrelatedtoidentificationandutilizationof HIVpre-exposureprophylaxis(PrEP)-relatedsupportandsocialsupportnetworkstructurewithinsocialsupport networksofYMSMofcolorreceivingPrEP;?and2)todeterminetheassociationbetweensocialsupportand currentandsustainedadherencetoPrEPamongacohortofYMSMofcolor.Toachieveaim1,wewillconduct amixedmethodsqualitativeandnetworkanalyticstudyusingin-depthinterviewsandsociogramstoexplore themesofhowparticipantsidentifyPrEP-relatedsupportfigures,howsocialsupportisstructured,andthe waysinwhichsupportfiguresmayfacilitatePrEPadherence.Foraim2,wewilluseacross-sectionalstudy designtotestforanassociationbetweensocialsupport,asmeasuredwithawell-validatedmulti-dimensional surveyinstrument,andcurrentPrEPadherenceusinganovelurineassaytodetecttenofovir;?anda longitudinalcohortdesigntotestforanassociationbetweensocialsupportasmeasuredaboveandsustained PrEPadherenceusingpharmacyrefilldata.TheproposedresearchisbothinnovativeandrelevanttotheNIH HIV/AIDSpriorityofsupportingresearchtodevelopmethodsofPrEPdeliverythatmitigateadherenceissues. Theproposedresearchwillrequireskillsinepidemiology,biostatistics,qualitativeresearchmethods,and networkanalytics.TheKirschstein-NRSAIndividualPostdoctoralFellowshipwillthusbeessentialtothe successofthisresearchbyprovidingfundingfortheapplicanttocompletequalitativemethodsand introductorynetworkanalyticscoursesthroughtheMastersofScienceinHealthPolicyResearchandprovide asecondyearofcoursesinadvancedtopicsinepidemiologyandnetworksunderthesupervisionofahighly qualified,multidisciplinarymentorshipteamwhowillguidethecandidateinhercareerdevelopment.The longer-termobjectivesoftheapplicantaretocompletedataanalysis,disseminateresultsthrough presentationsandpublication,andusetheresultsasafoundationforafutureKawardapplication.